Nice Quality Standards for IBD
Friday, 27 February 2015 10:42
Professor Chris Probert, Chair BSG IBD Section Committee
"The BSG welcomes the release of Quality Standards for IBD by NICE. The four statements are necessarily succinct and members should read the more detailed version on the NICE website. This document sets a standard that should be recognised by CCGs and Trusts and should enable us to raise the quality of our services. These standards should form the basis of the forthcoming IBD Accreditation, along with the IBD Audit and Registry."
Changes in HCV therapy - approval of Sofosbuvir
Friday, 30 January 2015 13:55
Dr Stephen Ryder, BSG Vice-President Hepatology & Dr Andrew Austin, Chair BSG Liver Section
There are two major changes in HCV therapy which now have NICE and/or NHSE approval for use. The first is that commissioning guidance for the use of Simiprevir is published (http://www.england.nhs.uk/commissioning/spec-services/npc-crg/group-a/a02/). This allows G1 patients without Q80K to access triple therapy now using Simiprevir instead of Boceprevir or Telaprevir.
The second and probably more significant development is the approval of Sofosbuvir. The approval can be summarised as below:
Sofosbuvir in combination with pegylated interferon + ribavirin (Peg-IFN+RBV)
|HCV genotype||Adult patient population|
|Genotype 3||Treatment-naïve with cirrhosisa|
|Genotype 4, 5, or 6||Treatment-naïve & experienced with cirrhosisa|
Sofosbuvir in combination with RBV
|HCV genotype||Adult patient population|
|Genotype 3||Treatment-naïve with cirrhosisb|
|Treatment-experienced with cirrhosisb|
The NHSE approval is for cirrhotic patients to access treatment in April with non-cirrhotic patients from July.
There is a meeting at Barts on 3rd March 2015 (advertised by BVHG) to establish clinical guidelines as to who to treat with what when. It is highly likely that by July other agents approvals will make the interferon component of the regimen outdated. NHSE will establish a process by which the drugs will be distributed shortly but it would seem prudent for centres to enter local negotiations now in order all are ready to prescribe when we are given the approvals. It is pretty certain that similar data gathering will be required as for EAP.
Lancet liver recommendations must be implemented to address crisis
Tuesday, 25 November 2014 00:00
The British Society of Gastroenterology (BSG) has today urged for the Lancet Commission UK Liver Disease Publication recommendations to be pursued "without delay" to "address the UK liver disease crisis".
Liver Disease mortality rates have increased by 400% since 1970 and is the third most common form of premature death in the UK.
The most common form of liver disease is alcohol-related, followed by fatty liver disease caused by obesity. The steep rise in both alcohol consumption and obesity in recent decades has led to increases in both conditions.
Incidences of chronic viral hepatitis are also on the rise, with annual deaths from hepatitis C having quadrupled since 1996, and significant increases in hepatitis B infection.
The Lancet report calls for wide-reaching, joined-up action including:
- Better detection of early disease in primary care
- Improved support services in community settings
- The establishment of Liver Units in District General Hospitals
- A national review of liver transplantation services
- Strengthening of continuity of care for children with liver disease surviving into adult life
- A range of population-level measures such as a minimum unit price for alcohol
- Promotion of healthier lifestyles with clearer government messaging and new regulations on the food industry
- Eradication of chronic HBV and HCV infection from the country by 2020
- Greater provision of medical training in hepatology
- A national campaign led by NHS England to increase awareness of liver disease in the general population
NICE Evidence Update: Acute Upper Gastrointestinal Bleeding
A summary of selected new evidence relevant to NICE clinical guideline 141 'Acute upper gastrointestinal bleeding: management' (2012)
This Evidence Update provides a summary of selected new evidence published since the literature search was last conducted for the following NICE guidance: Acute upper gastrointestinal bleeding. NICE clinical guideline 141 (2012) A search was conducted for new evidence from 23 September 2011 to 20 February 2014. A total of 6061 pieces of evidence were initially identified. After removal of duplicates, a series of automated and manual sifts were conducted to produce a list of the most relevant references.
- Download Update [ 0.5 Mb ]
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